Doctor Name: | MS. DEBORAH LUBERTHA JELLEMA |
NPI Number: | 1740446293 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.P.C., L.M.H.C. |
License Number: | 39001865A |
Business Practice Address: | 2325 177th St Lansing, IL - 604381722 |
Business Phone Number: | 7088957310 |
Business Fax Number: | 7088957602 |
Mailing Address: | 2325 177th St, LANSING |
State: | IL |
Postal Code: | 604381722 |
Phone Number: | 7088957310 |
Fax Number: | 7088957602 |
NPI Enumeration Date: | 08/04/2008 |
NPI Last Update Date: | 08/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 39001865A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |